Introduction: A multidisciplinary evaluation in paragangliomas (PGLs) is required given the potential complications present at the time of diagnosis or related to the surgical management. Case Report: A 26-year-old male, presented with anxiety, panic attacks, pallor, sweating, and distal tremor, BP 230/130 mmHg, was selected. Plasmatic-free metanephrines were 6,392 pg/mL (normal <149 pg/mL), and computed tomography showed an extra-adrenal retroperitoneal mass of 63 × 51 mm. Preoperatory management was difficult and presented hyper- and hypo-tension during surgery (conventional laparotomy). He presented a new episode of hypertension after surgery, that was associated with renal exclusion and without residual tumor. Conclusion: Young patients, with PGLs, have long-life expectancies and can benefit from an opportune diagnosis, interdisciplinary management, and prolonged follow-up.